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Sandy Srinivas, MD
Sandy Srinivas, MD
Posted: Tuesday, August 30, 2022
According to Savita Dandapani, MD, PhD; Claire Hao, BS; and Colton Ladbury, MD, all of City of Hope National Medical Center, Duarte, California, and colleagues, applying external-beam radiation therapy (EBRT) to oligometastases in patients with oligometastatic hormone-sensitive prostate cancer may improve clinical outcomes. Consequently, these investigators reviewed the long-term outcomes of these patients who were treated with EBRT and androgen-deprivation therapy on a clinical trial. Their findings were published in the International Journal of Radiation Oncology • Biology • Physics.
“Follow-up on this cohort has been limited to less than 5 years, and prospective data on de novo oligometastatic hormone-sensitive prostate cancer patients is lacking,” mentioned the study authors. “Our results compare favorably with other reported studies of oligometastatic hormone-sensitive prostate cancer and provide new insights into long-term outcomes a decade after treatment, warranting continued prospective exploration, particularly of de novo patients.”
The investigators focused on 29 patients with oligometastatic hormone-sensitive prostate cancer who harbored one to five metastases. A total of 15 and 14 patients had de novo and oligorecurrent disease, respectively; 21 participants had bone metastases. Participants underwent 36 weeks of androgen-deprivation therapy and up to 53 Gy to all identified metastases. The primary tumor or prostate bed were treated with EBRT up to 78 Gy or 66 Gy, respectively, upon clinician discretion. EBRT was administered to a total of 52 lesions located in the bone (n = 38), pelvic lymph nodes (n = 12), and lymph nodes outside the pelvis (n = 2). After a median follow-up of 9.9 years, the investigators observed a median overall survival of 9.7 years and a median progression-free survival of 1.9 years.
Individuals observed to have prostate cancer–defined de novo metastases had a significantly improved progression-free survival compared with those who had oligorecurrent disease (P = .04). Additionally, patients who presented with metastases located in the lymph nodes alone had an improved median progression-free survival compared with those harboring bone metastases (5.8 vs. 1.8 years). Of note, 17 participants had local control of all EBRT-treated metastases at last follow-up, and metastases that locally progressed were controlled for a median of 3.5 years.
Disclosure: For full disclosures of the study authors, visit redjournal.org.
International Journal of Radiation Oncology • Biology • Physics
